The long-anticipated implementation of ICD-10 coding finally began this past Thursday, October 1, 2015. As of that date, government and commercial payors ceased to accept claims under the old coding system (ICD-9). The transition has been five years in the making due to a government delay in 2012.
The new system has five times the codes of the prior system, including everything from “problems in relationship with in-laws” to “pedestrian injured in collision with roller skater” to “burn due to water-skis on fire”. The hope is that the breadth and detail of the new codes will provide greater accuracy and increase reimbursement rates. However, the complexity of ICD-10 could also cause substantial delays in reimbursement from both the provider side and the insurer side. While CMS and other insurers are committed to ensuring that the implementation of the new system is completed, it is up to each provider to prepare for and manage the transition in their own practice.
Here are a few tips for your practice during the transition:
- Mitigate the risk of longer-than-expected reimbursement times by setting aside a reserve fund to cover interim operating expenses, such as payroll, in the event of a one to two week delay in reimbursement during the next few months.
- For detailed information on ICD-10, including guides particular to your specialty, check out CMS’ Road to 10 webpage (accessible at this link: http://www.roadto10.org/) and ICD-10 Provider Resources page (accessible at this link: https://www.cms.gov/medicare/coding/icd10/providerresources.html).
- Whenever your staff has specific claims questions, contact the appropriate payor sooner rather than later.
- If you haven’t already, consult your practice management and EHR software vendors to find out how they recommend using their technology with the new coding system.
- In an effort to speed up the learning curve, consider asking your billing and coding staff to dual code a few charts each day. This will give them additional opportunities to train, while reducing the need for extra training sessions down the line.